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Something happens when you’re under a tight deadline, or serving during the dinner rush, or studying for a big exam. Your thoughts and emotions quiet down, and before you know it, hours have passed. The distraction that work, errands, to-do lists, and projects provide can be such a respite for our busy brains. We use it like a drug to resolve discomfort. So, this week Nzinga dives into the reasons so many of us can’t stop working and helps listeners identify whether or not they have a work addiction.

Show Notes 

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Here’s the Bergen Work Addiction Scale Nzinga mentioned to see if you’re addicted to work

Transcript

[00:53] Dr. Nzinga Harrison: Hey, all this is Nzinga. You are listening to In Recovery. For those of you who may be new to this show, let me tell you a little bit about the show and a little bit about myself. This show is about all things addiction, not just drugs, but things we wouldn’t necessarily think about, like work, exercise, sex, gambling. I guess we would sometimes think about those as addiction. And it’s question/answer. So what we’re really trying to do is answer the questions that people have about addiction. Our definition of addiction is that anything we keep doing despite negative consequences can qualify. And I’m your host because I’m a physician, psychiatrist, addiction expert. I’ve been practicing medicine for the last 20 years. This is my life’s work. I so believe in bringing compassionate, evidence-based addictions treatment care that I co-founded. Eleanor Health, where I’m the chief medical officer, where we are doing exactly that. 

 

[01:58] Dr. Nzinga Harrison: And because of kind of all of that logit street cred, I’m your host for In Recovery. So this week we’re going to talk about work addictions. But before we do, I just wanted to share with you guys one of the most exciting things that happened to me over the weekend, which is that my adjustable sitting/standing desk finally arrived. So it came in like five different boxes. I’ll tell you, I have scoliosis diagnosed in seventh grade, like, very narrowly, thank goodness, avoided surgery. And so back pain is not foreign to me. Sciatica is not foreign to me. Neck pain is not foreign to me. I have this really great formula. You’ll hear me talk about the magic formula as it relates to substance use, disorders and addictions care. But I believe in this for all of health. And so my magic formula is like yoga at least three times a week, running maybe once every couple of weeks. And when I say running, like, don’t get excited. I mean, like three quarters of a mile. OK. Because I do not enjoy it. And then seeing my chiropractor, if I have to, getting a therapeutic deep tissue massage monthly. 

 

[03:08] Dr. Nzinga Harrison: If I do that, I can pretty much keep sciatica and neck pain away. But then here came COVID. And COVID came and I’m sitting at the desk for 13 hours. No yoga, no running. You wouldn’t catch me going anywhere near a doctor’s office. So no chiropractor. Definitely not going to get a massage. So guess what? Neck pain on 10. Sciatica on 11. And so I was just like, finally, I have to do something about this. And I’ll share with you, actually, I was having a really hard time on Saturday, so I posted on Twitter, “I feel it all. And it’s so, so heavy.” And I was just like laying in the bed and I was like, overcome with the weight of the world. And so the way I get out of that is spending time with my family. My husband was working all day because busy. But my 14 year old Zahir has nothing better to do with his life than to help Mom put together her sit-down, stand-up desk. And it is amazing. So I spent the first couple of hours today standing. I spent the next couple of hours sitting. And now I’m sitting again and like literally I have no sciatica. I feel my neck pain starting to resolve. So there are lots of different options. But I encourage you: pull the trigger. Coronavirus has changed how much we’re getting up out of our seats and your body is feeling that. So that was the longest introduction ever. But I think a good segue into work, which is what we’re talking about today.

 

[04:50] Claire Jones: Yes. So I’m really excited to talk about work this episode, because I think it’s a little more confusing for me and doesn’t seem as straightforward. Ultimately, I love working, and I know that you are passionate and you love Eleanor Health. So for two people who relatively love their jobs, there’s still this feeling of like ugh I have to work or like, oh my God, I have so much work to do or blah, blah, blah. And yet I think we’re both addicted to work. You know, it’s like I thrive in that space when I’m like low to medium stressed-out about how much work I have to do. I want to know more about this, because it doesn’t seem to follow the sort of normal dopamine signal that we have been talking about so much in our first couple of episodes. 

 

[05:37] Dr. Nzinga Harrison: Yeah. So it actually does. Remember, it starts in the deep brain that we don’t control. It goes to that second neuron, comes up to the third neuron in the prefrontal cortex that says we need this to survive. It resolves danger. It resolves fear. It resolves anxiety. It resolve depression. Ao make sure we never go without this. Make a plan to make sure because we need this to survive. That’s why the dopamine pathway, I intentionally make sure to use the term, the motivation pathway as opposed to the reward pathway, because people think reward means you’re enjoying it or it’s positive. But people will tell you even with drug addiction, at some point, drug addiction is miserable. It’s awful. They’re suffering. And yet that dopamine pathway is still driving the cravings, and that message to the prefrontal cortex that we need this to survive. Even as the drug is killing you, the dopamine pathway is telling that prefrontal cortex we need this to survive. Find a way to never go without it. And so you can have that same concept for what’s happening with work. Right? People definitely work to their detriment. I have to keep really close tabs on myself because I’ll relapse to unhealthy work patterns very quickly. I’m actually in an unhealthy work pattern as we speak. So I’ll relapse to that to the point of neck pain, back pain, not spending time with my family, not doing things that I know drive my health right. 

 

[07:18] Dr. Nzinga Harrison: But at the very beginning, when I’m doing that, it feels good, because I love chopping stuff off my to do list. I can live in an Excel spreadsheet and when I get that sucker done it is like party time, like that was a hard spreadsheet. I love it, right? Yeah. So in the beginning it does feel good, but then at some point it’s like guilt: I should be hanging out with the kids. I should be hanging out with Joel. I should be doing yoga. Back pain: you need to get up from this chair night. Getting up. Neck pain: not getting up. Oh, you didn’t cook dinner. It’s your night still working. Oh, you could be watching a movie. I would rather be working. Even when it starts to feel bad, I’m still caught in that cycle. And it actually takes like a significant effort to get out of that cycle. And so when we look at — we’ve kind of defined on this show a three-stage addiction process that then turns into its own cycle, and it’s intoxication and then its withdrawal.  So you use whatever you do, the behavior, you get the intoxication, the satisfaction from it. Then you go in a period where you’re not using or not doing that behavior and you miss it, and you start to develop negative feelings as a result of that void of not doing that behavior. So maybe that work is piling up. Right? Maybe that’s my performance at work is going to suffer. People are going to notice I’m not working. Whatever the anxiety and the depression and the guilt, I should be working start to build up. Maybe I’m missing out on something if I don’t check email. All of those things start to build up and then those drive forward to the prefrontal cortex to engage the craving part of the cycle. And the craving part of the cycle is basically the dopamine system telling the prefrontal cortex, you feel all these negative feelings, you feel that guilt, you know what will take that guilt away? Work. You feel that stress building, you know what will take that stress away? Work. You feel yourself feeling unsure whether you’re being a good employee or not. You know what will take that feeling away? Work. And so it drives you back to work. So when you think of it that way, it’s actually the same cycle. 

 

[09:39] Claire Jones: Yeah, that definitely makes sense. I mean, I even think about it in the context of, like, social anxiety. And sometimes work doesn’t necessarily mean Lemonada. Like, sometimes for me in the hours after work, what work feels like is doing something that’s productive. For me, that’s like reading, writing, exercising, cooking a nice meal. All of these other things, sometimes I have to fill my days so much with tasks that when I slow down or have an opportunity to slow down, I will find ways to not slow down and to fill my free time with tasks.

 

[10:22] Dr. Nzinga Harrison: And that’s using it like a drug, right? So what you’re talking about is kind of being unable to tolerate quiet space. So we’re getting here into this concept of mindfulness. And I am 100 percent there with you. Like when I stopped doing yoga for a while, as I have stopped for this while that we’re currently in, when I get back to doing yoga, I literally start with 10 minute videos, because I have to work my brain stamina back to being able to be quiet. I don’t have a quiet brain. My brain is noisy and chaotic. And to your point, work pulls that together for me. Also, if I’m just sitting somewhere with “nothing to do,” then I’m like, let me find something to fill this space because it feels uncomfortable to me to have a quiet brain. And so I use yoga and mindfulness to help increase my stamina for having a quiet brain. And for sure, when I’m on my yoga schedule, I can stop myself from working more easily at the end of the day, because I’m not having negative anticipation about quiet time, because I can tolerate quiet time more successfully. And actually, that was like not even a mindful way to say that, because the whole point of mindfulness is like not judging what’s going on in your brain or in that moment. It’s just like, oh, this is the moment, I recognize this is the moment, I accept this moment for what it is. And so part of that when I say that, is using work like a drug, so think about this concept of using fill in the blank to resolve discomfort. And that discomfort is, oh, my mind is racing. That’s usually going to be alcohol or Xanax or Ritalin or Adderall or something like that. And it’s like I can’t tolerate not having my brain engaged because then who knows what sorts of things we start thinking about. 

 

[12:30] Dr. Nzinga Harrison: Who knows what kind of pain we start dealing with. So I’ve actually just put this quote on Facebook, I want to say it was either Friday or Saturday morning, because I already told you all I hit the wall on Saturday and I was like, I’m out. So it was either Friday or Saturday morning. And it said — and I wish I could remember who to attribute this quote to because I’d be trying to give people their props — but it said “people cling onto their hate because without it, they would have to face their pain.” And so I think we could say the same thing about working to our own detriment is like clinging on to work, lest we have to face whatever else is going on in our hearts and our brains and our lives. That’s what happened to me this weekend. I have been working working working. And anti-racism, which that’s been my whole life, since I could walk and talk, my dad had me on a picket line. Anti-racism work comes easily to me. But even in that anti-racism work, that’s me avoiding the piece of that work that touches my kids. And as soon as I touch that piece of work, bam, I’m crunched. So it’s like even as I’m doing the work, I can still use the work from a distraction from that kind of pain. 

 

[16:13] Claire Jones: Let’s talk about work stigma a little bit, but then also stigma of success in America, because I think that’s also an element to this in some way. 

 

[16:25] Dr. Nzinga Harrison: For sure. I mean, we start getting trained in the United States of America literally from the time you come out of the womb, everybody’s waiting for your next milestone. Like, you literally just got born today. And it’s like, oh, when are you gonna gain another ounce? Oh, when are you going to say mama? Oh, when are you going to sit up? Oh, when are you going to roll over. Oh, when are you gonna walk? Like we are a very not mindful culture in that we always need the next best thing. And it’s like, well, my baby walked at nine months. How old was your baby when your baby walked? Oh, my baby is already saying words. Oh, my toddler is already reading. Oh, my middle schoolers are already in coding. Like we’re such a competitive culture. But even more so than being competitive is that we benchmark our value outside of ourselves. And I think this is a lot to your point where this stigma around not having work because who are you, if you don’t have a career?

 

[17:37] Dr. Nzinga Harrison: You’re useless. You’re nobody, you have no value. Even if you have a career, if it’s not one of the, you know, respected careers, then you don’t have any value. And it’s like the more we could be mindful, and try to start raising our kids from the beginning, like your value is intrinsic. So your value doesn’t come from what you do, your value comes from who you are. But we’re a long way from that. And it’s hard. My kids have two high-performing parents. High-performing by every traditional definition. Dad’s an entrepreneur. Mom’s a doctor. We have money. We have a house. Went to great colleges. You name it, we can check the box. And so we actually had a hard time in the beginning because we intentionally wanted to raise our kids that your value is not what you do, your value is who you are. And when I say we had talented kids, I mean, like put them in the water and they can swim fast. Put them in a class and they can read fast. And it’s so ingrained in us to constantly be praising them for the things they’re doing, praising them for the first place, praising them for their A in class, praising them for the positive feedback that somebody else said that we had to, like, be very intentional about praising them for who they are. And saying like, oh, it’s great that you got first place. Like, we love it. We’re celebrating. But what we’re celebrating is the effort you put in to get that first place. Or we saw you be really nice to that person, and we’re praising that. Or we saw you stand up for that person when you could have stayed quiet, and we’re praising that. And so trying to really decouple their academic performance and their sports performance as things they do. And that’s great. And we enjoy that. But we value you even if you weren’t doing any of those things, even if you were doing those things and coming in last place. As long as you were trying. Even if you get a C now, you know, that one was hard. OK, but I told them, if you get a C, and you made your best effort, nobody’s getting in trouble. It’s hard because we’re programmed from the time we come out of the womb. 

[20:13] Claire Jones: Right. So I also want to talk about this a little bit in the context of racism and anti-racism, because this is important to incorporate into an ongoing conversation about all of this stuff. 

 

[20:27] Dr. Nzinga Harrison: Yes. So just for the record, racism is everything related. So, yes, it’s gonna be work related. It is everywhere at all times. Our senior director of National Clinical Operations and quality at Eleanor Health co-facilitates our racism, oppression, culture and recovery training, which is part of new staff training for every single person that starts Eleanor Health. And what she says is racism is the ocean we swim in, if we’re fish. It’s the air we breathe. It literally permeates everything. So, yes, it permeates work because what are we just finished saying? In this country, your professional accomplishments define your value. And so a lot of the ways black and brown people have tried to overcome the devaluing of black and brown people is to excel at work. Talk to any black or brown person and they’ll tell you their parents raised them and said, “you have to be twice as good to get half as far.” And it’s true. But the difficulty there is what if you’re one and a half times as good, then unfortunately we’re internalizing that as my value as a human, as opposed to the quality of the work I can do or the quantity of the work that I can do. And it’s like you can’t climb to a higher-quality concept of yourself, or the people you’re working with, a higher concept of quality in their eyes without working twice as hard, twice as long. And so that’s driving — going back to what is the pain that it’s resolving? What is the danger that it’s resolving? It’s the danger of having to experience 100 percent racism instead of maybe 95 percent because you made it up a level at work. So very related. 

 

[22:35] Can I ask you a question that is not necessarily related to this episode? I mean, I feel what is going on as much as I can as a person who has not lived this my whole life, you know, it’s like I can empathize to a certain point, but at the end of the day, I’m a white person. And I guess I’m curious, just like where do you feel it in your body? That heaviness. 

 

[23:10] Dr. Nzinga Harrison: I wasn’t gonna cry today, but I feel it in my chest. It feels like I have the elephant sitting on my chest. And it usually comes — and this is what happened over the weekend. I have huge emotional capacity and huge cognitive capacity until it comes to my kids. And so it was — I didn’t watch it because I knew I was gonna kick me over the ledge. But then I watched it, the video of the police following those two teenagers who were just walking down the street being kids and then ultimately throwing that kid to the ground, putting the cuffs on the other kid. And those kids are the same age as my kids. From the back, those are my kids. And it just completely kicked me over the edge. And so I can approach this work, even though it’s my own experience, I can approach the work of anti-racism pretty cognitively most of the time. Every now and then, I’ll get emotional about it and I’ll be like, burn the whole place down! Like, that’ll happen. But most of the time, I can approach it pretty cognitively just because I know what the brain is doing, I know that the brain is not always reflecting people’s intentions. In general, I believe in good intentions from people. I can access those things very easily. But when I see those things happening to kids and when I think about it affecting my own kids, like literally my cognitive reserve goes out the window, and it is just an elephant on my chest. And that’s what I was dealing with Saturday. I laid in the bed. I cried in the bed by myself. I watched some, like, useless TV. I did zero work, which is unlike me, because I love working. And when I get stressed out, I work and then I feel better. And I was just like, I can’t even work. None of it matters. None of it is important. I’m not on social media. I’m not talking to anybody. Like, I just went into a cocoon to, like, let myself take the space to get that elephant off my chest. But it’s 100 percent goes in my chest like it feels like it suffocates me. So now you got me crying. Thanks, Claire. 

 

[25:40] Dr. Nzinga Harrison: Speaking of how racism intersects with work. There’s this hashtag on Twitter right now, and it’s called #Blackintheivory hashtag. I encourage all of you to take a look. So I’m Twitter lame. OK, I’m not good at it. So I miss all of these things when they come. But I was on Facebook and somebody posted the link of a tweet from actually my close friend Edjah Nduom, co-founder of Physicians for Criminal Justice Reform. Actually, he’s the founder, I’m the co-founder. So we work closely together. We both went to Penn med. He’s like significantly younger than me. So he was coming in when I was going out. He’s a neurosurgeon now. And he posted this story when he was a medical student interviewing for neurosurgery residencies, which is extraordinarily competitive, as you might imagine. A very small group of people that have big influence over career paths. And so he was in this interview and he’s from Ghana, and the neurosurgery chair said, oh, you’re from Ghana? And he’s like, yes. And he says, oh, that’s good. Let me ask you a question. He goes on this long, meandering story is around the time of Katrina. And the folks are you know, he’s thinking to himself, those people, they’ve lost everything. They have nothing and they’re suffering. I was wondering, like, if I just chartered some cruise ships to send them to Africa, if that would help. Well, I mean, it sounds kind of like get on a boat and go back to Africa, poor people. And so my friend, now neurosurgeon Dr. Edjah Nduom, is a medical student whose entire future career in neurosurgery hinges on his ability to come up with a non-offensive comment at the moment. Now, mind you, he tells the story beautifully, like go check it out on Twitter. His heart’s pounding, his palms are sweaty, his mouth is dry. He has literally just been racism assaulted. And it is on him, a medical student, because literally that guy could go and tell all of the neurosurgery chairs don’t accept this kid into your program. And his future in neurosurgery is down the tubes before it even starts. 

 

[28:14] Dr. Nzinga Harrison: So, yes, it has to do with work because these types of I mean, you could call it microaggression, even though that sounds like a macro. They’re happening at work. And so check out that #blackintheivory. I saw his story and I was like, oh, I just told my quick little story, which, if you ask me, is dramatically less egregious than that, but just illustrative of what it is to be a black person in what should be the most benign of circumstances and the way you work to undermine the pain. Because what do you do? He came up with some answer there that wouldn’t, like, get him ousted. And then he works three or four times as hard as a neurosurgeon to undermine the perception of him as one of the only black kids coming to try to be a neurosurgeon. But mine, so I went to Howard, I had 3.9 GPA, high MCAT scores. I did research in Japan. I was a good candidate. I come into Penn med. I end up being the first black president, a medical student government, you know. I did well academically. I graduate from medical school. I get a lot of awards. This is the point of the story. I get all of these awards, so it’s like time to check out and we’re closing things down about the finished medical school, go on to the next phase of my medical training. And my medical school dean says, “Nzinga, I’m so proud of you. You came in a piece of coal and look how we’ve shined you up.” So, yes, racism has everything to do with work.

 

[29:59] Dr. Nzinga Harrison: I said to her “I was shiny when I got here.” Because, you know, my mouth is smart and quick. It’s not the best professional move. I’ve learned to navigate these things more deftly. She said, “see, that’s your problem, you have a hard time taking a compliment.” Which she truly thought she was giving me. Like, you’re so shiny, and we did that for you. And that’s not to say medical school didn’t make me shiny because it did. Obviously, the growth that you make from undergrad to being a doctor is unparalleled growth. And so what did I probably do? I probably went and started working on how to get more black people into Penn med. I went and I started studying for residency, when I go in this residency, they’re gonna know I’m shiny when I walk in the door. They’re not going to think they made me shiny. And so, to your point, the pain of racism. Yes. Affects every single thing. And do we work to try to undermine that pain? Yes. The pain of depression, anxiety, guilt, feeling unsure about your skills as a parent? Easier to work. Totally having trouble in your marriage? Easier to work. Fighting with your friends? Easier to work. And then work becomes its own detriment.

 

[33:28] Dr. Nzinga Harrison: So let me get into some nuts and bolts, because we’re talking about the concept of a work addiction. But, you know I always like to be a little scientific about it. So we talked about the brain, of course. But I want to give some people some like for-real practical resources, rather than just kind of like waxing philosophically. So the question then is going to be, is it work addiction just because I work long hours? Or how do I know if I might be at risk for work addiction, or how do I know if I might be displaying symptoms of work addiction? So the first answer is that the DSM-5, which is our diagnostic manual for psychiatry, mental health disorders, does not define work addiction. Even though it’s not in the DSM-5, there are pretty widely agreed upon set of symptoms that represent work addiction and they track right along with all of the other addictions we’ve been talking about, substance addiction, sex addiction. And so when we look at these criteria, about five to 10 percent of the U.S. population meet these criteria. That’s one in 10. Or one in 20 on the low end. Still, that’s a lot. You know, 20 people. Some of the studies actually estimate as high as 25 percent. But those are older, before they were like more agreed upon what it looks like. So let’s use five to 10 percent. So that’s a lot. The reason I’m saying that is because that’s five to 10 percent of the general population in the United States of America. 

 

[35:06] Dr. Nzinga Harrison: If we took a population of people that work long hours, it’s going to be a higher percentage of those folks that would meet the diagnostic criteria, even though I just said to you there’s no official diagnosis by DSM that would meet the criteria for work addiction. But it’s not one to one. So, yes, you can work 120 hours per week, says every medical resident in training, and not have a work addiction. So let’s talk about what symptoms I’m talking about. Number one, there’s this Bergen work addiction scale. We’re going to drop it in the resources. The Bergen work addiction scale has seven questions and you rate them from one to five. And it’s basically how often do you do this thing? And one is never. And then five is always. And then in between. Rarely, sometimes, often. On these seven things. if you answer often or always to more than three, chances are you’re looking at a work addiction. All right. So let’s go through what these seven are. Number one, you actively think of ways you can free up more time for work. I will give myself sometimes on that. Although now in the COVID environment, it increased my workload exponentially. And then George Floyd’s killing and the protests and all of this opportunity for anti-racism work, which I am not going to let fly out the door, increased it another exponential factor. So I am definitely like what can I move around to make more time for work right now.? Number two, you spin much more time working than you initially intended. 

 

[37:13] Dr. Nzinga Harrison: This exactly mirrors drinking more than intended, using more than intended in our substance use disorder criteria. Number three, you work in order to reduce feelings of guilt, anxiety, helplessness and depression. Number four, you have been told by others to cut down on your work, but you didn’t listen. That’s not exactly how the criteria is written. It says you have been told by others to cut down on work without listening to them. You become stressed if you are prohibited from working. So remember that three-part addiction cycle I talked about? Intoxication, which would be working, withdrawal, which is not working, and then the craving, so the development of that negative emotional state when you’re not working, which drives you back to work. This is one of the criteria. Next, you de-prioritize hobbies, leisure activities and exercise because of your work. That’s straight out a substance use disorder criteria. So in this case, the substance is work. And then, final bullet point, and I’m gonna go into a little bit of detail here. You work so much that it has negatively influenced your health. It’s easy for people to think about how work has negatively influenced their mental health. I was stressed out. I got depressed. My self-esteem went down. I’m anxious before I go to work. But work addiction has actually been associated with — well, let me start with myself. Back pain. Neck pain. Carpal tunnel. So all the musculoskeletal stuff.

 

[39:07] Dr. Nzinga Harrison: Chest pain and shortness of breath from anxiety and panic attacks. But also suppression of your immune system. Now, that’s the one I think people are gonna say, what?! And suppressing your immune system — so, like, do you ever notice you’re like, oh, my God, I’ve been working so crazy. Every single time you’re working so crazy seems like you come down with a cold. Coincidence? I think not. It is not a coincidence. It’s literally because you’re working so much, that usually affects your sleeping, usually affects your eating, usually affects your water intake and your stress is up. So stress suppresses your immune system. All of that other stuff being out of balance suppresses your immune system. And basically, we live in a world of germs. So viruses and bacteria and fungi and algae, all of that stuff is around us at all times. We’re breathing it in, we’re touching it, we’re putting it in our mouths, we’re rubbing it on our faces, like, all of the time. 

 

[40:07] Dr. Nzinga Harrison: It’s just that your immune system is protecting you from it. So then when you decrease your immune system ability to do its job, you get sick. And then do you stay home? No, you do not. And so you’re sick and you’re working and it’s this negative cycle. So one, two, three, four, five, six, seven. If you answered often or always to three or more of these, you are likely in the active phase of a work addiction. And so what do you do? It’s going to be the exact same thing like we talk about with substance addiction. Number one is you need to get a full mental health evaluation. The number of people for whom a depressive disorder is driving a work addiction, an anxiety disorder is driving a work addiction, a substance use disorder is contributing to a work addiction, ADHD is driving a work addiction because you can’t pull your thoughts together and so you have to work three times as much to get the same amount of work done. We have to know what all of those things are. And you might get your evaluation and it’s like, oh, just work addiction. Let’s figure it out. Or it may be work addiction plus. And if it’s work addiction plus, if we’re not evaluating that past history of trauma that’s the source of the pain, racism that is the source of the pain, that depressive disorder that’s the source of the pain, those marital difficulties that are the source of the pain. Your child with their own needs, that are the source of the pain. If we don’t get at the pain, we can’t get at the addiction. So get a full 360 degree evaluation and then your plan is going to be biological.

 

[42:16] Dr. Nzinga Harrison: So what can you do to replace the dopamine from work with dopamine from something else? Food, water, sex, nurturing, exercise, sunlight, warm bath. Like all of these things. How do you replace that biological signal? Psychologically, what is the pain? How do we deal with it. Socially. what are the stressors? How do we reduce them. Cultural politically, how are you feeding yourself and getting life meaning and making a difference in the world? 360 degree magical formula. Trust and believe, just like all other addictions, this is a remitting relapsing condition. So right now I’m telling you I am in relapse. I have got to get it together. OK, mindfulness. I’m not judging myself over that, but I am giving myself a little accountability by saying it on this podcast, because then next week, Claire ought to be like, what parts of your formula have you started working? Engage your support system.And start to recognize what are those triggers? What are the triggers that take you back to work addiction? Because you can be in remission and you can be working your formula. And here will come a trigger that can try to push you back into it. So have your relapse prevention plan in place. Have your accountability buddy. Make sure you get at it from all 360 degrees.

 

[44:03] Claire Jones. Wow. You blow my mind every time. I went back into TED talk mode. I was like, Oh my God, this is so fascinating. I mean, I knew I was addicted to work, but now I really know 

 

[44:50] Dr. Nzinga Harrison: Listeners, get yourself an accountability buddy. These are our two questions. How much did you work last week? Should we set a goal for the upcoming week? Yeah. Or maybe even day by day, honestly. Day by day work goal, and for the weekends or whatever the equivalent of your weekends are from work. So hopefully two days that you’re not working. Recognizing that it’s a privilege. But if you have that, then what will you be doing that is not work? So how will you be getting your dopamine from elsewhere? I like that a lot. The other thing I do too, which is like a practical strategy I try to use for myself, because it is really, really hard for me to get up from work at the end of the day. I enjoy work, I enjoy feeling productive. I’m literally on a high. I’m like, Oh. After my meetings end, I’m checking stuff off my to do list, I’m like, oh, you’re killing it. Bam! Nailed it. Can’t tell me nothing. Right. This is the end of my work day. And it’s like stop it. Get up. And it’s like, oh, I’ll just do this one more thing. 

[45:59] Dr. Nzinga Harrison: Ask yourself, does this have to be done today? And if the answer is no. Make yourself leave. And from working from home, that’s harder, right? Because leaving might just be whatever, walking to the next room. But get up. Close it down. Make yourself leave. And like we said in the technology episode, don’t take your laptop with you. Make yourself have some work free time. Give yourself a cut off. 

 

[46:28] Claire Jones: That’s what I was going to say. I feel like especially with COVID, having some kind of separation, whether that’s a room, whether that is just something you do right when work is over so that your brain enters not work mode. 

 

[46:47] Dr. Nzinga Harrison: Yes. Because COVID really took that from a lot of us. I know the reason I used to leave work at a reasonable hour was because I had to pick the kids up from school or I had to go to a tennis match or I had to go to a swim meet or I had to go to archery practice. So when all of those things disappeared, here’s my confession: in the beginning, I was like, yes, I can work all the way until 7:30 without feeling any guilt for missing out on family time. Like that’s pathological. I was like, oh, and maybe I could even push it until eight. And then I was like, I pushed it until eight and nobody in the family said anything. And I’ve been working from like 7 a.m. to 8:30 p.m. like every day. And for what? I can do that crap tomorrow. 

 

[47:38] Claire Jones: I have a clarifying question. So when you say people should seek out a full mental health evaluation. Is that something that comes from doctors? Is that something that comes from therapy? What is that exactly? 

 

[47:51] Dr. Nzinga Harrison: Yeah. Thanks for asking. So I would not point people immediately to a doctor. I would point you to a therapist. I would say a licensed clinical social worker or a licensed professional counselor or a licensed marriage and family therapist or a doctorate level psychologist, a clinical psychologist. So any of those disciplines can do a comprehensive mental health evaluation with you, and actually help you start putting in the parts of your magic formula, figuring out what those are. And then if there is anything that looks like it may be amenable to treatment with a medication, they can get you referred to a psychiatrist or psychiatric practitioner that can help manage that part for you. But you don’t have to start with a physician. 

 

[48:39] Claire Jones: OK. And do you go in and you’re like, this is what I think is going on? Or do ask for that exam? 

 

[48:47] Dr. Nzinga Harrison: Yes. So I would say go ahead and fill out your Bergen work addiction scale and take it with you and say, I am working to my detriment, and I listened to this podcast called In Recovery and it said that this is usually associated with some other type of pain. So I’m here to figure out — I need a full assessment to make sure nothing else is contributing, and some help figuring out what my formula is going to be so I can get my work addiction in remission. And they will be like, oh, snap!

 

[49:25] Claire Jones: And that can be for anything we’ve talked about. I feel like you do a great job of providing these online sort of like tests or gauges for different stuff we’ve talked about. So for any subject, you can go on and be like, hey, I heard that I might have this fill in the blank addiction on this podcast. But then you can get a full on assessment and see what’s going on. 

 

[50:04] Dr. Nzinga Harrison: Yes. And what’s the thing I always say every single episode, Claire? Even if you take this work addiction test, this inventory, and it says, no, there is no problem. The fact that you ask the question — because what we’re trying to do is start recognizing what’s going on with ourselves earlier in the process and addressing it before the answer becomes yes. So even that you just said, hmm, what is this? Maybe let me go take this, because maybe this applies to me or this has something to do with me. That’s enough of a signal.

 

[50:49] Dr. Nzinga Harrison: All right. Thank you, everybody, for listening. I hope I didn’t go on and on for too long about my own attempts to get in recovery from work addiction. I hope it was helpful. If you heard something that you think was worthwhile, please tell everybody you know to listen. Hope you’ll tune in next week. 

 

[51:12] Dr. Nzinga Harrison: In Recovery is a Lemonada Media original. The show is produced by Claire Jones and edited by Ivan Kuraev. Music is by Dan Molad. Jessica Cordova Kramer and Stephanie Wittels Wachs are our executive producers. Rate and review us and say nice things. And follow us @LemonadaMedia across all social platforms, or find me on Twitter @naharrisonmd. If you’ve learned from us, share the show with your others. Let’s help destigmatize addiction together.